Prospective Quality of Life Outcomes in Pediatric Fecal Incontinence Following Bowel Management

Space: StayCurrentMD Author: Irene Isabel P. Lim, Christopher C. Cushing, Todd Jenkins, Misty Troutt, Margaret H. Zeller, Monir Hossain, Beth Rymeski, Michael Helmrath, Jason S. Frischer Published:

Author / Expert

Irene Isabel P. Lim, Christopher C. Cushing, Todd Jenkins, Misty Troutt, Margaret H. Zeller, Monir Hossain, Beth Rymeski, Michael Helmrath, Jason S. Frischer

Topic overview

Abstract

Background

Severe fecal incontinence (FI) is common in patients both with and without anorectal malformations. Whether a formal bowel management program (BMP) has significant effects on FI, psychosocial development of the child, and caregiver stress is poorly understood. We hypothesize that BMP participation results in long-term clinical and quality of life (QOL) improvements for patients and caregivers.

Methods

Using a prospective cohort study over three years, 342 children (age 3-12 years) and caregivers were followed for one year after attending a week-long BMP, during which a regimen was tailored to promote daily stool evacuation. FI QOL was measured with the validated Cincinnati Fecal Incontinence Scale (CINCY-FIS), evaluating multiple subscales, including parental stress. Scores were obtained at multiple timepoints following BMP (baseline, 2 weeks, 3 months, 1 year).

Results

Within 2 weeks, BMP participation significantly improved FI with increased frequency of daily daytime voluntary bowel movements (20% to 70%, p

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